Healthcare Provider Details

I. General information

NPI: 1538375068
Provider Name (Legal Business Name): NEFERTARI DAAGA ESEMUEDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W MILLER ST
ORLANDO FL
32806-2031
US

IV. Provider business mailing address

83 W MILLER ST
ORLANDO FL
32806-2031
US

V. Phone/Fax

Practice location:
  • Phone: 407-898-6588
  • Fax: 407-389-5312
Mailing address:
  • Phone: 407-898-6588
  • Fax: 407-389-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME111328
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: